Recovery of cognitive function and mood after severe hypoglycemia in adults with insulin-treated diabetes
Open accessAbstract
OBJECTIVE: Acute hypoglycemia in humans impairs cognitive functions and alters mood states. The time required for cognitive functions and moods to return to normal after an acute episode of severe hypoglycemia is unknown. RESEARCH DESIGN AND METHODS: Cognitive functions and moods were studied prospectively in 20 subjects with insulin-treated diabetes who had recently experienced a spontaneous episode of severe hypoglycemia ("hypo" subjects) and 20 matched control subjects with insulin-treated diabetes who had not experienced severe hypoglycemia during the preceding year. The hypo subjects had a history of a greater number of episodes of severe hypoglycemia (P = 0.000). Cognitive function tests and mood scales were administered at 1.5, 9, and 30 days after the severe hypoglycemia and at similar intervals for the control subjects. RESULTS: For most of the cognitive tests, no evidence of a "hangover" effect of the acute hypoglycemia on cognitive function was observed (P > 0.05). A trend was noted for levels of hedonic tone (P = 0.082) and energetic arousal (P = 0.053) to improve with time in the hypo subjects but not in the control subjects. However, the hypo subjects had chronically elevated levels of depression (P = 0.011) and anxiety (P = 0.049) and persistently performed more poorly in several cognitive tests, such as the Digit Symbol Test (P = 0.009) and the Stroop Task (P = 0.007). CONCLUSIONS: These results suggest that, in general, recovery from any acute cognitive decrement after severe hypoglycemia was complete by 1.5 days. The cognitive decrements and altered mood states noted in the hypo subjects may be persistent and may be a consequence of previous exposure to recurrent episodes of severe hypoglycemia.
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Patients with recurrent hypoglycemia have been found to have chronic mood disorders including depression and anxiety, although it is hard to establish cause and effect between hypoglycemia and mood changes.
“Patients with recurrent hypoglycemia have been found to have chronic mood disorders including depression and anxiety (85,86), although it is hard to establish cause and effect between hypoglycemia and mood changes.”
From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [86]
Patients with recurrent hypoglycemia have been found to have chronic mood disorders including depression and anxiety, although it is hard to establish cause and effect between hypoglycemia and mood changes.
“Patients with recurrent hypoglycemia have been found to have chronic mood disorders including depression and anxiety (85,86), although it is hard to establish cause and effect between hypoglycemia and mood changes.”
From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [86]
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Neuropsychological Sequelae of Type 1 and Type 2 Diabetes
Holmes, C. S., Morgan, K. L., & Powell, P. W. (2019) · Springer eBooks · doi:10.1007/978-3-030-14895-9_24 · Cited by 1 · see citing works
Cryer, P. E., & Frier, B. M. (2004) · International Textbook of Diabetes Mellitus · doi:10.1002/0470862092.d0707 · Cited by 1 · see citing works
Self-citationRobinson, R., & Paulose, C. S. (2007) · Dyuthi Digital Repository (Cochin University of Science and Technology)
Cognitive impairment following severe hypoglycaemia: response to Kubiak et al.
Strachan, M. W. J., & Frier, B. M. (2005) · Diabetic Medicine · doi:10.1111/j.1464-5491.2005.01710.x
Self-citationDepression: Risikofaktor für den Typ-2-Diabetes?
Albers, B., & Icks, A. (2010) · Der Diabetologe · doi:10.1007/s11428-009-0532-8
Case Study: Cognitive Impairment, Depression, and Severe Hypoglycemia
Zrebiec, J. F. (2006) · Diabetes Spectrum · doi:10.2337/diaspect.19.4.212
Neuropsychological Sequelae of Type 1 and Type 2 Diabetes
Holmes, C. S., Morgan, K. L., & Powell, P. W. (2010) · Springer eBooks · doi:10.1007/978-1-4419-1364-7_22
Severity of Type 2 Diabetes Mellitus, Working Memory, and Self-care
Gatlin, P. K. (2012) · UA Campus Repository (The University of Arizona)
Type 1 Diabetes and Disordered Eating Behaviour: Exploring the Role of Executive Function
Broadley, M. M. (2018) · Queensland University of Technology · doi:10.5204/thesis.eprints.122229
- Authors
- Strachan, M. W., Deary, I. J., Ewing, F. M., & Frier, B. M.
- Affiliations
- Edinburgh Royal Infirmary (GB)
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2000-03-01
- Volume
- 23
- Issue
- 3
- Pages
- 305-312
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2107051924
- Cited by
- 113
- References
- 9
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 3 · 2019: 3 · 2018: 5 · 2017: 4 · 2016: 8 · 2015: 7 · 2014: 7 · 2013: 6 · 2012: 3
- FWCI
- 2.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Neurological and metabolic disorders
- Keywords
- severe hypoglycemia, cognitive function, mood, insulin-treated diabetes, depression, anxiety, hedonic tone, energetic arousal, recurrent hypoglycemia, Stroop task, digit symbol test
- MeSH terms
- Adult, Affect, Blood Glucose, Cognition, Diabetes Mellitus, Type 1, Female, Humans, Hypoglycemia, Insulin, Intelligence, Male, Memory, Neuropsychological Tests, Time Factors, Wechsler Scales
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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